<!DOCTYPE html>
<html lang="en" xmlns:th="http://www.thymeleaf.org">
<html lang="en">

<head>

    <meta charset="utf-8">
    <meta http-equiv="X-UA-Compatible" content="IE=edge">
    <meta name="viewport" content="width=device-width, initial-scale=1">
    <title>肺炎疫情健康状况调查表</title>

    <!-- CSS -->

    <link rel="stylesheet" th:href="@{/css/style-main.css}">
    <link rel="stylesheet" th:href="@{/css/pintuer.css}">
    <!-- Javascript -->
    <script th:src="@{/js/jquery-1.11.1.min.js}"></script>
    <script th:src="@{/js/jquery.backstretch.min.js}"></script>
    <script th:src="@{/js/pintuer.js}"></script>
    <script th:src="@{/js/scripts.js}"></script>
    <!--    <script th:src="@{/js/jquery-3.5.1.min.js}"></script>-->
</head>
<body>


<!-- 登陆 -->
<ul class="nav nav-inline nav-menu navbar-right">
    <li>
        <a class="" href="javascript:;">
            <span><img th:src="@{/images/logo2.jpg}" width="28" class="radius-circle"></span>
            [[${session.username}]]
            <span class="downward"></span>
        </a>
        <ul class="drop-menu">
            <li><a class="icon-user" target="_blank" href="javascript:;">修改资料</a></li>
            <li><a class="icon-key" target="_blank" href="javascript:;">修改密码</a></li>
            <li><a class="icon-exchange" target="_blank" href="javascript:;">注销</a></li>
        </ul>
    </li>
</ul>

<!-- 表单 -->
<div class="top-content">
    <div class="inner-bg">
        <div class="container">
            <div class="text">
                <h1><strong>肺炎疫情</strong> 健康状况调查表</h1>
                <div class="description">
                    <p>
                        请如实填写相关信息！
                    </p>
                </div>
            </div>
            <div class="form-box">
                <div class="form-top">
                    <div class="form-top">
                        <form th:action="@{/userinfo/submit}" method="post">
                            <div class="form-group margin-big-top">
                                <div class="label">
                                    <strong>您的学号/职工号？</strong>
                                </div>
                                <div class="field">
                                    <input type="text" name="userid" th:value="${session.userid}" class="input"
                                           placeholder="学号/职工号"/>
                                </div>
                            </div>

                            <div class="form-group margin-big-top">
                                <div class="label">
                                    <strong>1、您的姓名？</strong>
                                </div>
                                <div class="field">
                                    <input th:value="${session.username}" type="text" data-validate="required:必填"
                                           name="q1" class="input"
                                           placeholder="请填写你的姓名"/>
                                </div>
                            </div>
                            <div class="form-group margin-big-top">
                                <div class="label">
                                    <strong>2、你今天的体温是多少度？</strong>
                                </div>
                                <div class="field margin-big-left">
                                    <label>
                                        <p><input id="check1" name="q2" data-validate="radio:请选择"
                                                  onclick="hideQuestion()" value="37.2℃及以下" type="radio">&nbsp;37.2℃及以下
                                        </p>
                                        <p><input id="check2" name="q2" onclick="showQuestion()" value="37.3-37.9℃"
                                                  type="radio">&nbsp;37.3-37.9℃
                                        </p>
                                        <p><input id="check3" name="q2" onclick="showQuestion()" value="38℃及以上"
                                                  type="radio">&nbsp;38℃及以上</p>
                                    </label>
                                </div>
                            </div>
                            <div class="form-group margin-big-top">
                                <div class="label">
                                    <strong>3、你目前是否在校？</strong>
                                </div>
                                <div class="field margin-big-left">
                                    <label>
                                        <input id="q3" name="q3" value="是" type="radio" data-validate="radio:请选择">&nbsp;是
                                        <input name="q3" value="否" type="radio">&nbsp;否
                                    </label>
                                </div>
                            </div>
                            <div class="form-group margin-big-top">
                                <div class="label">
                                    <strong>4、你目前所在城市？</strong>
                                </div>
                                <div class="field margin-big-left">
                                    <select data-validate="required:请选择城市" id="q4" class="input" name="q4">
                                        <option value="无">无</option>
                                        <option value="湖北省">湖北省</option>
                                        <option value="湖南省">湖南省</option>
                                    </select>
                                </div>
                            </div>
                            <div id="box1">

                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>5、你是否或曾经有疑似/确诊新冠肺炎？</strong>
                                    </div>
                                    <div class="field margin-big-left">
                                        <label>
                                            <p><input data-validate="radio:请选择" id="q5" name="q5" value="否"
                                                      type="radio">&nbsp;否</p>
                                            <p><input name="q5" value="新冠肺炎疑似病例" type="radio">&nbsp;新冠肺炎疑似病例</p>
                                            <p><input name="q5" value="新冠肺炎确诊病例" type="radio">&nbsp;新冠肺炎确诊病例</p>
                                            <p><input name="q5" value="已解除" type="radio">&nbsp;已解除</p>
                                            <p><input name="q5" value="已治愈" type="radio">&nbsp;已治愈</p>
                                        </label>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>6、你是否有发热、咳嗽等症状？</strong>
                                    </div>
                                    <div class="field margin-big-left">
                                        <label>
                                            <p><input data-validate="radio:请选择" id="q6" value="否" name="q6"
                                                      type="radio">&nbsp;否</p>
                                            <p><input value="发热" name="q6" type="radio">&nbsp;发热</p>
                                            <p><input value="咳嗽" name="q6" type="radio">&nbsp;咳嗽</p>
                                            <p><input value="其他症状" name="q6" type="radio">&nbsp;其他症状</p>
                                        </label>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>7、近期（15天内）你是否与新冠肺炎病人（含疑似病例人员）接触？</strong>
                                    </div>
                                    <div class="field margin-big-left">
                                        <label>
                                            <input name="q7" value="否" type="radio" data-validate="radio:请选择" id="q7">&nbsp;否
                                            <input  name="q7" value="是" type="radio">&nbsp;是

                                        </label>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>8、你当前是否被医学隔离？</strong>
                                    </div>
                                    <div class="field margin-big-left">
                                        <label>
                                            <input name="q8" value="否" type="radio" data-validate="radio:请选择" id="q8">&nbsp;否
                                            <input  name="q8" value="是" type="radio">&nbsp;是

                                        </label>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>9、你的家人是否或曾经是新型冠状病毒肺炎（含疑似）病人？</strong>
                                    </div>
                                    <div class="field margin-big-left">
                                        <label>
                                            <p><input data-validate="radio:请选择" id="q9" name="q9" value="否"
                                                      type="radio">&nbsp;否</p>
                                            <p><input name="q9" value="新冠肺炎疑似病例" type="radio">&nbsp;新冠肺炎疑似病例</p>
                                            <p><input name="q9" value="新冠肺炎确诊病例" type="radio">&nbsp;新冠肺炎确诊病例</p>
                                            <p><input name="q9" value="已解除" type="radio">&nbsp;已解除</p>
                                            <p><input name="q9" value="已治愈" type="radio">&nbsp;已治愈</p>
                                        </label>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>10、近期（15天内）你的家人是否与新冠肺炎病人（含疑似病例人员）接触？</strong>
                                    </div>
                                    <div class="field margin-big-left">
                                        <label>
                                            <input name="q10" value="否" type="radio" data-validate="radio:请选择" id="q10">&nbsp;否
                                            <input  name="q10" value="是" type="radio">&nbsp;是

                                        </label>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>11、你是否有学业、心理、经济困难等方面的事项，如果是请填写</strong>
                                    </div>
                                    <div class="field">
                                        <textarea data-validate="required:必填" id="q11" class="input" name="q11" rows="5"
                                                  cols="50"
                                                  placeholder="最多填写300字，最少填写1字"></textarea>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>12、你的紧急联系人姓名</strong>
                                    </div>
                                    <div class="field">
                                        <input data-validate="required:必填" id="q12" type="text" name="q12" class="input"
                                               placeholder="姓名"/>
                                    </div>
                                </div>
                                <div class="form-group margin-big-top">
                                    <div class="label">
                                        <strong>13、你的紧急联系人电话</strong>
                                    </div>
                                    <div class="field">
                                        <input data-validate="required:必填" id="q13" type="text" name="q13" class="input"
                                               placeholder="联系电话"/>
                                    </div>
                                </div>

                            </div>

                            <div class="form-button margin-big-top navbar-right">
                                <button class="button border-sub" type="submit">
                                    提交
                                </button>
                            </div>
                        </form>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <!--底部-->
    <div class="container-layout">
        <div class="border-top">
            <div class="text-center">
                <ul class="nav nav-inline">
                    <li class="active"><a href="#">网站首页</a></li>
                    <li><a href="#">新闻资讯</a></li>
                    <li><a href="#">产品中心</a></li>
                    <li><a href="#">技术反馈</a></li>
                    <li><a href="#">留言反馈</a></li>
                    <li><a href="#">联系方式</a></li>
                </ul>
            </div>
            <div class="text-center height-big">
                版权所有 Pintuer.com All Rights Reserved，图ICP备：380959609
            </div>
        </div>
    </div>
</div>

<script>
    function hideQuestion() {
        $('#q5').prop('checked',true);
        $('#q6').prop('checked',true);
        $('#q7').prop('checked',true);
        $('#q8').prop('checked',true);
        $('#q9').prop('checked',true);
        $('#q10').prop('checked',true);
        $('#q11').val('无');
        $('#q12').val('无');
        $('#q13').val('无');
        $('#box1').hide();
    }

    function showQuestion() {
        $('#q5').prop('checked',false);
        $('#q6').prop('checked',false);
        $('#q7').prop('checked',false);
        $('#q8').prop('checked',false);
        $('#q9').prop('checked',false);
        $('#q10').prop('checked',false);
        $('#q11').val('');
        $('#q12').val('');
        $('#q13').val('');
        $('#box1').show();
    }
</script>

</body>

</html>